Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 29868 | IA |
N | 2081P2900X | Pain Medicine | 29868 | IA |
NPI | 1306898556 |
---|---|
Provider Name | Margaret Ann Mulderig |
First Address | Edina, MN 55435-1908 |
Second Address | Saint Paul, MN 55102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 11/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F86356 | (02) |